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@ARTICLE{Paul:291060,
      author       = {C. Paul and B. Schöttker$^*$ and M. Hartmann and H.-C.
                      Friederich and H. Brenner$^*$ and B. Wild},
      title        = {{G}ender-specific factors associated with case complexity
                      in middle-aged and older adults-{E}vidence from a large
                      population-based study.},
      journal      = {International journal of geriatric psychiatry},
      volume       = {39},
      number       = {6},
      issn         = {0885-6230},
      address      = {Chichester [u.a.]},
      publisher    = {Wiley},
      reportid     = {DKFZ-2024-01281},
      pages        = {e6113},
      year         = {2024},
      abstract     = {To investigate gender-specific factors associated with case
                      complexity in a population-based sample of middle-aged and
                      older adults using a holistic approach to complexity.Data
                      were derived from the 8-year follow-up home visits of the
                      ESTHER study-a German population-based study in middle-aged
                      and older adults. Cross-sectional analyses were conducted
                      for 2932 persons (aged 57-84). Complexity was assessed by
                      the well-established INTERMED for the elderly interview,
                      which uses a holistic approach to the definition of case
                      complexity. The association between various
                      bio-psycho-social variables and case complexity was analyzed
                      using gender-specific logistic regression models, adjusted
                      for sociodemographic factors (age, marital status,
                      education).Prevalence of complexity was $8.3\%$ with
                      significantly higher prevalence in female $(10.6\%)$
                      compared to male $(5.8\%)$ participants (p < 0.001).
                      Variables associated with increased odds for complexity in
                      both, women and men were: being divorced (odds ratio [OR]
                      women: 1.86, $95\%$ CI 1.05-3.30; OR men: 3.19, 1.25-8.12),
                      higher total somatic morbidity (women: 1.08, 1.04-1.12; men:
                      1.06, 1.02-1.11), higher depression severity (women: 1.34,
                      1.28-1.40; men: 1.35, 1.27-1.44), and higher loneliness
                      scores (women: 1.19, 1.05-1.36; men: 1.23, 1.03-1.47). Women
                      (but not men) with obesity (Body mass index [BMI] ≥30) had
                      higher odds (1.79, 1.11-2.89) for being complex compared to
                      those with a BMI <25. High oxidative stress measured by
                      derivatives of reactive oxygen metabolites in serum was
                      associated with 2.02 (1.09-3.74) higher odds for complexity
                      only in men.This study provides epidemiological evidence on
                      gender differences in prevalence and factors associated with
                      case complexity in middle-aged and older adults. Moreover,
                      this study adds to the holistic understanding of complexity
                      by identifying novel variables linked to complexity among
                      middle-aged and older individuals. These factors include
                      loneliness for both genders, and high oxidative stress for
                      men. These findings should be confirmed in future
                      longitudinal studies.},
      keywords     = {Humans / Female / Male / Aged / Middle Aged /
                      Cross-Sectional Studies / Aged, 80 and over / Germany:
                      epidemiology / Sex Factors / Logistic Models / Prevalence /
                      Risk Factors / Loneliness: psychology /
                      bio‐psycho‐social (Other) / complexity (Other) /
                      loneliness (Other) / older adults (Other) / oxidative stress
                      (Other)},
      cin          = {C070},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38877644},
      doi          = {10.1002/gps.6113},
      url          = {https://inrepo02.dkfz.de/record/291060},
}